Experiencing Music Therapy Cancer Support Support.pdf · Experiencing Music Therapy Cancer Support MARY H. RYKOV Toronto, Canada Abstract I portray health-related research outcomes

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Experiencing MusicTherapy CancerSupportMARY H. RYKOVToronto, Canada

Abstract

I portray health-related researchoutcomes in an arts-informedrepresentation that disrupts thetraditional discursive-scholarly formatof journal writing to privilege betterthe participants’ accounts andcommunicate these experientially. Therepresentation uncovers meaningthrough alternative ways ofcommunicating and conveys theineffable quality of music in a mannerthat may be understood through andbeyond words. This expands theconvention of health-related researchoutcomes, including ways of knowing,what can be known and how this canbe represented. I elaborate myintentions for this experiential report,discuss theoretical underpinnings ofthis methodology and describe amusic therapy support group model.

Journal of Health PsychologyCopyright © 2008 SAGE PublicationsLos Angeles, London, New Delhiand Singaporewww.sagepublications.comVol 13(2) 190–200DOI: 10.1177/1359105307086708

AC K N OW L E D G E M E N T S . I thank 10 cancer patient-survivors without whomthis research report would not be possible. This research was supported by anoperating grant from the Sociobehavioural Cancer Research Network withfunds from the Canadian Cancer Society. I was supported for this researchthrough a PhD studentship (Award #014484) at the University of Toronto,supported by the Canadian Cancer Society. This writing is extracted from myarts-informed PhD dissertation. I acknowledge Ardra Cole, Margaret Fitch,Denise Grocke, Sandra Trehub, Dave Hunt and Arthur Frank for their carefulexamination of this work.

C O M P E T I N G I N T E R E S T S : None declared.

A D D R E S S . Correspondence should be directed to:MARY H. RYKOV, PhD, MTA, FAMI, PO Box 142, Station C, Toronto,Ontario, M6J 3M9, Canada. [Tel. +1 416 538 2271;email: [email protected]]

Keywords

� arts-informed research� cancer support group� music therapy

(VIVIAN wakes in horrible pain. She is tense, agi-tated, fearful. Slowly she calms down and addressesthe audience.)

VIVIAN: (Trying extremely hard) I want to tell youhow it feels. I want to explain it, to use my words …(Edson, 1993/1999, p. 70, emphasis in original)

The experience

The experience of first starting another supportgroup got me a bit unsettled—what’s that going tobe like? Why am I here? What am I hoping to gainfrom this experience?

I’ve always liked music. When I sing along withrecords in the privacy of my home, I sing just like them.[group laughter] And if anybody was to hear me, they’djust tell me to be quiet, which is what they did when Iwas a kid. So, I am very self-conscious about it.

I realized just how scared I was to sing with people.Am I ever going to get over this? I just feel immedi-ately that I’m going to go on and crack, take the wrongkey, and everything and anything that is unattractive.

I was excited when I saw the notice about the musictherapy group. I called and wanted to come, andcame. And in a way I wasn’t really sure what wasgoing to happen. But I found that I was really look-ing forward to coming every time. That regardlessof outside things or the illness, regardless, I alwaysfelt better when I was here and felt better when I leftand really hated it that time I couldn’t come.

It’s just a great feeling to walk through these doorseach week. From one o’clock to three o’clock I’ll befree to focus on this and drop everything else in mybusy life and just come in here and create.

We’re there for the purpose of experimenting aboutmusic and we’re all doing it and we’re all doing a reallygood job. And, as you know I expressed the first time,

I wasn’t going to sing. And then I found by the secondtime I sang and I didn’t care if I was going off key andso I didn’t go off key and I was pretty impressed.

It’s very healing to not judge ourselves, to be com-passionate and just to be part of a group, to feel partof a community. I felt like it was a community andthat’s very healing.

While the group was going I never felt separatefrom everyone. Thank you so much because thathappens a lot.

I find those few hours a week that I participate in thegroup very soothing and healing—creating a senseof well-being. I really mean creating vs feeling asense of well-being. It, creativity, becomes thefocus, the energies of exploring beyond our regularexperiences. Very little in our life becomes a creativeenergy. Most of the things I do have become routine.

Something really magical happens with the groupenergy. And any inhibitions that you might have aboutbeing able to play music or make music, that you loseyourself within the group, and almost become, likeone. We forget ourselves and we stop thinking.

There’s an energy in the group that, to me, acts as itsown catalyst. So it just keeps rolling along.

RYKOV: EXPERIENCING MUSIC THERAPY CANCER SUPPORT

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Figure 1. View of the Music Therapy Centre street front.

Figure 2. Inside the front door of the Music TherapyCentre.

Figure 3. Large clinic room before group.

I don’t find it to be much different—the cancer jour-ney for everyone is the same in so many ways anddifferent in everyone’s way. And so it doesn’t matterwhat our definitions are of what cancers we have orwhat age we are or what gender or what our name iseven, just the fact that we were together and it wasone song. That was just the most important part.

Because of the group I actually started listening tomusic more. Not actually getting CDs out and lis-tening to them but just when I hear a song playingon the radio as I was walking by a restaurant I take note. Or during group I would notice we’reactually singing and humming with each other. AndI thought this is a great environment. Like, I startedactually responding to that more and I startedremembering it. And I wrote down in my journalsongs, songs that started popping up into my head.Those things were there and I used to do that before,take note of music more. But then when I got sick itseemed to be something I put on the shelf. So thatreally started to feel good.

Today at the music therapy group when we sang, Ifelt that my heart was singing. I felt that my voicewas reverberating this sweet sound of joy, of happi-ness to my body parts that have been sad anddepressed for so long.

I thought I didn’t like to drum but I converted. It justkind of took off. [giggle] We were playing off eachother. There was something that was happening tothe whole group. And I don’t know what happened,but it happened. I was thrilled. I felt elated, uplifted.It felt good. And it stayed with me.

Drumming was something I have never donebefore. Beating my hands on the drum was like aresonant sound that wanted to come from within thevery core of my being. To see and hear all of usenraptured in that creative moment, to let go to themusic, to our heartbeats, to the calling of our soulsto play together. Drumming was shouting our anxi-eties away. Drumming was telling our bodies not togive up. The crescendo in the drumbeats, and all ofus moving to that crescendo without any orders everbeing spoken or directions being given.

I enjoyed the drumming very much. I felt it as amystical experience, primal and simple, which con-nected me with something very deep inside myself.It was as if this deep component had awakened,come out and joined the rest of the people.

Creating our own music and conducting it was verytouching for each person. Each one of us felt likereal creators, and allowing other people to expresstheir creativity and just being with them and feel-ing them joining in that creative process was very

rewarding. I felt like I accomplished somethingthat came as close to being creative as I will everbe. I really felt that as long as I live, I will proba-bly not be given another opportunity like thatagain.

It sounded like raindrops.

It sounded like chimes.

It sounded as if everybody had written the musicspecifically in that way as opposed to people justdoing something on their own. And, as well, I defi-nitely was in the moment, which is not usual for me,which is nice.

Music goes to your viscera. It’s in your sternum orin your stomach. It’s not just in your head or in yourears.

It is an incredible way to pass the time in a healthyway. It’s not a bad thing to be playing music andlosing yourself in something that’s creative. Andrealizing later that you’ve made that, that it wasn’tsomebody else just showing you a movie. No, youwere making something and you lost yourself in itand you didn’t feel pain anymore.

I had an interesting sort of emotional experiencethis week. I realized that I am going to be in treat-ment for the rest of my life. I’m going to have tolive with the side effects of that. And so I might aswell get used to it and not let it dominate. And, ofcourse, the point is not how long you live butwhether you’re living while you’re doing it. So thatgave me a lot of energy, despite the aches and pains.I think that I have been waiting for something to beover and then I’d be sort of normal again. And thisis normal now.

Ran an unexplained fever, felt pretty horrible.Had to cancel dinner plans with friends. Is it aside effect? A recurrence? Food poisoning?Every little thing that comes along—is this it?!Once your body betrays you, it’s hard to trust itagain.

JOURNAL OF HEALTH PSYCHOLOGY 13(2)

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Figure 4. Instruments.

I feel isolated with cancer. Because it’s happeningto me, I feel isolated. Most people don’t actuallyknow what it feels like. I feel like I’m on the topof a very high mountain and the tip is very sharpand I could lose my balance at any minute. That’sisolation.

I see isolation outside this group. We understandeach other. But outside the group it is more difficult.Talking about cancer they have another perceptionthan us. I don’t talk about it because I know myfriends won’t understand.

Cancer. Marital problems. Sexual problems.Money problems. And I’m supposed to be cheerful?

It’s a humbling experience to be confronted withyour mortality.

You feel like a leper ’cause people are really avoidingthe conversation and think that they are being helpfulby not mentioning it. You feel like you’re a bad personbecause you got cancer and now you’re putting friendsthrough this uncomfortableness. Now they can’t talkto you the way they normally do.

I realized, as I was looking at my family, that weare all individually and collectively strugglingtowards a new normal, a new definition of whatthis family is and represents and what new valueswill emerge—family values and personal values,as well.

Well, I had a week of rejecting my normal. I’m sickand tired of being bored. That’s what fatigue does toyou. I started cutting things out of my life because Ijust wasn’t capable of doing them. And I realizedI’m not doing anything.

Since the beginning of my illness I am trying not tothink about it all the time and read about it all thetime. I want to work because I can forget that I havecancer. I want to work because I don’t want to think.

The chemo just destroyed me, physically. I hadaches and pains throughout my whole body. I amstill not recovered. And after that I had radiation andI’m still not recovered from the burns. On top ofthat I had depression and I didn’t understand it. Thatmade it even worse. I’m working with a therapistnow. I’m more positive than I was a year ago.


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Figure 5. Scanned journal entry (fish).

Figure 6. Scanned journal entry (needle).

Cancer certainly presents a barrier with some people.I really don’t like it when people ooze compassion.There’s a kind of sickening sympathy, which kind ofdepersonalizes you. Even if they’re trying to be cheer-ful, it’s distancing. My friends were talking about mycourage. And I thought, ‘What’s courage got to dowith it?’It doesn’t feel like courage to me—it feels likea struggle. It was distancing, the fact that they wereseeing what I was saying as courageous.

Being present in the moment is hard to do right nowbecause I am at that point in treatment recovery whereI can be almost obsessed by prevention. How can Iredefine myself? And it’s not letting me just be myself.

The positive-thinking prison, I call it. It’s just thisprison that people put you in. If you don’t think pos-itively, your cancer is going to come back, youknow. You have to be positive. You can’t let this getyou down. You have to be strong.

There’s another whole thing that I’m not dealing withand that’s the fear. And I’m not dealing with itbecause I don’t know how. But I know what the fearis about. The fear is about dying. Not being dead, butdying—the process of dying. Are the kidneys going topack in, is my back going to start disintegrating? Youknow, that sort of thing. But it doesn’t sound good.

I felt sadness (a recurrent theme for me) during thesinging. Its roots are very old. As kids I (we) was ina house with a lot of depression. There was no ‘highenergy fun’. I eventually concluded that I’m notsupposed to enjoy myself. The high I experienceddrumming was great but I felt embarrassed by myenergy level.

I’ve been very depressed for about a week. I’vebeen there before. It’s very difficult. I realize Ispend a lot of time in my head. Emotional energy,not sure if it’s going in or out. I was very emo-tional during the imagery. Sad. No body sensationor location for the sadness. I don’t know what todo with that energy, that sadness. I go through itquite regularly. I’m also aware how reluctant I amto talk about it in the group. I don’t want to tellmy friends about it. I’m sure I’ll get through it.[sigh]

When others talk about their cancer, it can be somekind of a mirror of what is going on inside me. Forme, sometimes when I don’t want to talk aboutcancer, that’s what I really need to do. There aretimes when I’m talking about it all the time and Ireally need not to. I don’t think I walk away fromhere feeling depressed because I talked about can-cer. I wasn’t depressed when I came in, so whyshould I be?

Our stories can be taken away from us in theirtelling, but no one can take away and re-tell theemotional and creative experiences we created,shared, reciprocated, appreciated and valued. Themusic experience is a process that is spontaneouslyin the moment. It’s not written, it’s not recorded. It’sjust felt, expressed, explored and loved by us all. Itunites us, in that moment, and it makes me feel spe-cial as a creative human being to be honoured by all of us being together, and feeling that power ofcreativity.


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Figure 7. Scanned journal entry (body).

Figure 8. Artwork following group guided Imagery &Music.

It taps into a whole realm of perception and commu-nication that is often neglected. It kind of expands you.

Music is a universal voice that allows us to say thingsthat we haven’t been able to put words to yet. And thefact is that everyone else there has experienced simi-lar things to you, so they understand.

As I was playing I realized that I was carrying a lotof anxiety and stress that I felt I needed to control.But during the playing I felt a great need to allow thedrums to soothe the range of emotions that I was feel-ing. Anger at being ill came to mind, but I realizedthat I was angry not so much at being ill, but that Ialso wanted to remove my fears from upcoming doc-tors’ appointments to tell me what my next course oftreatment is. I drummed so hard, hoping that the beatwould heal me, and make me whole again. It feltgood. In discussion it became very apparent that weare all touched by the experiences we share. Eachone of us leaves this space and time feeling better.

Communion is what it felt like for me. And just bymaking music. I tried very hard not to be competi-tive and that way I wouldn’t worry about it. I justfelt like I was part of it. I found it so thrilling and allI was doing was shaking those little shakers. But Istill felt part of it. And I had fun even if I wasn’tdoing anything particularly.

In music, we are all together and this is very impor-tant because doing music together helps us to becomemore aware of our internal connectedness, that we areall the same. And this is beautiful. And I think that this

is the feeling that we get from this group workingtogether, because it helps us to develop this feeling weare connected, we are the same. Yeah, there was likea kind of harmony in all of us together.

You allow your creativity to come out and others dothe same. Many cancer patients have problemsrepressing feelings and there is a lot of fear becauseof the diagnosis so I think that any therapy thatallows you to free those fears and blockages willhelp. And if you can get connected to yourself andconnected to others, it’s the healing process.

I feel this acute sense of self—a heightened aware-ness of everything that is me that I wasn’t aware of before having cancer. It pulls you into yourself.A few of my friends have actually commented onthat.

When others tell their stories, it sometimes bringsup things you haven’t really dealt with yet. This canbe painful. But it’s not harmful because, in a way,that’s really helpful.

I think it’s easier to talk about your fears onceyou’ve bonded through the music.

Sometimes I have been tired when I came here butafterwards I feel very calm and relaxed. For me,being part of the group is rejuvenating.

When the music-making started, I felt very tired andexhausted and stressed, heaviness in my shouldersand neck. As we continued, I felt release of tensioncoming off my shoulders. I felt the tiredness leave mybody, and a great sense of well-being generating inmy body. A calmness and peace entered my body. Ifelt more centred and energized. I felt at peace whenI left the session.


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I was really tired that day and all I know is that itfelt—you know, I think I just completely lostmyself in the music. I just felt like I wasn’t hereand no one else was here but it was just thesound. It was like a pulse running through myblood giving me oxygen for the soul. It felt like itwas feeding me.

It was so much more powerful than any of us.

It was a very sacred space that was created, I think.

I’d rather make music than describe what I feel aboutthis group. It’s really joyous. There wasn’t a day Ididn’t step out of the door with a bounce in my stepbecause of the energy that everyone contributed.

I let go of stress that I was feeling. I was allowed to becreative and explore different musical instruments thatwould connect me to the rest of the group. I was happyI came. I felt elated, and connected again. Very healing.

It was like a whole orchestra with no rehearsal.

It felt like, to me, a whole lot of kids playing. Justplaying and having a good time.

Was it really about the music? No, more than any-thing, the experience was about all of us, being inthat space and sharing and learning. Music was atool that we used to explore and ‘explain’ our feel-ings. Music was a way of gently easing our pains,and talking of our hopes and dreams.

I felt total unconditional love from you all. Whenwe all came in we were nervous, we didn’t knowwhat to expect. But it seems every week that wentby we opened more to each other. That, to me,has been the healing part. Just being in a groupand feeling like you can be yourself—that youare totally accepted and cherished for who youare. So it has helped me to accept myself morebecause of the validation you [the group] havegiven me.

This has surpassed any idea I could ever have.Making music with people is just magic. Andmaking music with people you have gotten to knowon such an amazing level in such a short period oftime because of our common suffering, if you will,has been an extraordinary experience. And I reallythink it helped. As I monitor my own reaction to lifeas it comes at me over these last couple of weeks,things changed.

You know that the pauses between, and thedynamics of, the music showed me that there wasso much more of unspoken language with musicthat we don’t talk about with words, that we canonly talk about with music. And there is somethingso incredibly beautiful about that, just to be able tobe free with sound in a group, with a group ofpeople who’ve come there to create this space tocommunicate.

Any illusion of control I thought I had in my lifewas destroyed when I received my cancer diagno-sis. Here in music therapy the music is neitherdirected nor controlled, but created—like a life.This was very empowering.

Experiencing the experience

MY INTENTIONS for this arts-informed phenom-enological report are three-fold. First, my intentionis to honour directly the experience of theresearched—the participants—in a manner thatstrives to emulate their creativity and risk-taking. Iincorporate non-verbal, visual means to enable theparticipants to ‘show’ what cancer is like. And I letthem ‘talk’ about music therapy using their ownwords without further elaboration or analysis fromme. In addition, opportunities to hear the partici-pants making music can be accessed on-line(http://hdl.handle.net/1807/4797).

Second, my intention for this research represen-tation is to honour the lived experience of music.True to the flow of music itself, the music therapyexperiences reported previously are uninterrupted


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Figure 11. View from large clinic room to front door.

by section headings. There are no disruptions toannounce, for example, that we are ‘leaving the keyof D major now and bridging the modulation to Bb

minor’. Also similar to music, the intention is to beimmediate and engaging but there are no one-to-onetruth correspondences. Meanings are open-ended,indeterminate and ambiguous.

Third, my intention is to perpetuate ‘new paradigminquiry’ (Finley, 2003) methods and representationthat expand the conventions of research form andchallenge the myth of the primacy and transparencyof language. Corrine Glesne (1997) likens experi-mental form to a clearing in the woods:

Experimental form is an opening, a clearing in thewoods of research regularities. The clearing away ofaccustomed practices releases a rare feeling of reflec-tive play … In this opening, light shines on intercon-nections among researcher and participants. Readersare invited to join in, not only with critique, but alsowith their feelings and personal reflections. Theclearing ruptures traditional patterns of scientificknowing and notions of research purposes. No longercontent to just ‘understand,’ the writer of experimen-tal form seeks … transformative powers … to open,in some way, all participants: researcher, researched,and readers. (Conclusion section, para. 1)

I further acknowledge that using the arts in and asresearch constitutes a political stance. I report theseresearch findings in an equitable manner intendedfor a wide readership beyond professional and aca-demic audiences. I challenge the hierarchical notionof what constitutes ‘knowledge’, ‘truth’ and ‘fact’ inresearch process and research representation.

This documentation is intended to be vicariouslyevocative so that the reader experiences, to someextent, cancer, music therapy and music therapy can-cer support. I employ an experiential methodology inthe interpretivist paradigm rooted in a lineage ofsocial science theory stemming from Dilthey(1831–1911) that includes Husserl (1859–1938),Merleau-Ponty (1908–1961), Gadamer (1900–2002)and Habermas (1968/1971).

Dilthey’s legacy to the history of ideas is monu-mental. Of note is his contention that methods used instudies of the physical world (Naturwissenschaften)to quantify and to explain causes are not appropriatefor use in the human studies (Geistwissenschaften) todescribe fully and understand experiences. Other con-tributions of his methodology to the methodologyemployed in the study reported here are his inclusionof literary works as valid sources of knowledge, and

his belief that all study should begin with examinationof complex experience in the human world. (Dilthey,1976).

Merleau-Ponty’s (1945/1958) phenomenologywas derived from Husserl’s (1970) ontology (beliefsabout being in the world) and epistemology (beliefsabout what we can know)—that all we can know isbeing/existence (Dasein) in the intersubjective life-world (Lebenswelt). Merleau-Ponty points to theprimacy of direct, embodied experience, that ‘theworld is not what I think, but what I live through’(1945/1958, p. xviii). These worldviews provide thefoundation for Gadamer (1989), a student ofHeidegger, who further developed his teacher’shermeneutic phenomenology, claiming that we can-not understand experience outside of the context ofour own subjectivities.

Habermas (1968/1971), a student of the FrankfurtSchool, articulates a questioning of science (amongother things) that echoes a postmodern challengefound in the science studies literature (for example,Haraway, 1991; Harding, 1991; Latour, 1999). Theinterpretivist paradigm may be seen as a Kuhnian(1996), constructivist, poststructuralist answer to thischallenge that arose to provide different lenses andmethods for inquiry of issues and questions that can-not be adequately described, explored or understoodby objective, atomistic, positivist means. Interpretivistinquiry—where truth is multiple, partial, situated andconstructed—enables multiple ways of knowing(Berger & Luckmann, 1966) where the arts conveytruths equal to and different from science.

Forinash and Grocke (2005) detail the variousways that phenomenological inquiry has beenemployed in music therapy research. This musictherapy phenomenological inquiry, predicated onhuman science theory and interpretivist methodol-ogy, is articulated here in an arts-informed (Cole &Knowles, forthcoming) representation.

Two elements inherent in constructing knowl-edge when using arts-informed research (Cole &Knowles, forthcoming) are:

1. it is grounded in a particular orientation of thequalitative research paradigm, which in this caseis phenomenology. At the point of that ground-ing the researcher is inspired through, by and/orin the arts and the intuitive, structured and procedural elements of that form; and

2. there are possibilities of reporting the researchin ways that hearken to the arts modality andform, and that these ways and means need notrely on textual representation alone. Indeed, the


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arts may also be incorporated at the inceptionof a project when formulating the researchquestion (Austin & Forinash, 2005).

Similar to the interpretive research paradigm inwhich arts-informed research is grounded, thereare no prescribed methods for using the arts inresearch, nor is there one correct method. Rather,the researcher finds what makes inherent goodsense for what she or he is trying to do. There areno scripts or formulas to be followed. Theresearcher must risk charting a new path that facil-itates the goals, skills and intentions of the project.This is distinct from other phenomenologicalmethods that specify prescribed procedures (e.g.Giorgi, 1985).

Furthermore, the whole story can never be toldand no inquiry can ever be complete or definitive.As van Manen (1990/1997) points out, rather thantelling the whole story, phenomenology ‘addressesany phenomenon as a possible human experience. Itis in this sense that phenomenological descriptionshave a universal (intersubjective) character’(1990/1997, p. 58).

The music therapy group ascancer support

The music therapy experiences reported here pertainto eight weekly groups that met for two hours as partof a phenomenological inquiry during May and Juneof 2004. Most of the research participants were self-recruited by means of an invitation flyer posted inhospital cancer departments, community settingsand newsletters. One was referred by a family physi-cian and another by a psychologist.

Ten individuals (nine women, one man) partici-pated in the study. They ranged in age from 24 to 72years and had diverse cancer diagnoses at differentstages of the disease trajectory. Many participants(six out of 10) had advanced (i.e. metastatic, recur-rent or multiple) disease. Three were receivingtreatment for their cancer during the group and twomore began treatment shortly after the group ended.Two have since died.

The participants had various musical back-grounds and preferences. Two of the participantshad some previous music skill but were not profes-sional musicians. All others were non-musicians.One participant derived great joy from playing adigital keyboard synthesizer but otherwise had nomusical instrument skills.

Early in the life of the group I actively providedstructure (Lieberman & Golant, 2002; Toseland &Rivas, 2005) but as the participants gained familiaritywith the music materials and each other, the contentand direction of the sessions was increasingly deter-mined by them. Music therapy experiences includedsinging, vocal improvisation, instrumental improvisa-tion, music listening, adaptations of the BonnyMethod of guided imagery and music (Bruscia &Grocke, 2002) and art processing of the music-evokedimagery, collective imagery and music and optionaljournal writing. Had the life of the group been longer,song-writing might also have been incorporated(Baker & Wigram, 2005). There was an emphasis onself-expression through improvised music makingthat facilitates group cohesion (Burns, Harbuz,Hucklebridge, & Bunt, 2001; Waldon, 2001). A play-ful, aesthetic context fostered an atmosphere con-ducive to building trust, empathy and intimacy.

All individual meetings (initial and follow-up) andthe music therapy group sessions were audio-recorded. The research data included text (transcribedindividual and group meetings, journal entries, sessionevaluation forms), music (pre-recorded, vocal andinstrumental improvisation, song), images (pho-tographs of settings and instruments, participant art-work and journal entries) and numbers (descriptivestatistics). In addition to the main research question—the meaning of the music therapy support group forthe participants—the research data were analysed (i.e.viewed, read and heard) intuitively and repeatedlyusing a set of steering questions until no new informa-tion was forthcoming. These questions pertained to themeaning of music and the music therapy group for theparticipants, how this music-oriented group differsfrom verbal support groups, what participants sayabout their cancer experience and what they say beforeand after music making. Interpretation of this empiri-cal data was guided by reflection on van Manen’s(1990/1997) lifeworld existentials (i.e. lived time,lived body, lived space and lived relationship) and byreading related research, poetry and fiction.

A music therapy support groupmodel

The group model described here is informed by fem-inist theory (Burstow, 1992, 2003; Hadley, 2006;Maracek, 2002), empowerment practice (Parsons &Gutier Cox, 1998) and support group self-helpphilosophies (Daste & Rose, 2005). Common to all


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these approaches is a striving for empowerment as a process and a goal. The model is framed by relational-cultural theory in therapy (Jordan &Hartling, 2002; Worell & Remer, 1996/2003) and it isinfluenced by the radical pedagogy movementwhereby therapy clients are perceived to be learnersand therapy is re-conceived as ‘education-about-the-self’ (Rykov, 2006, p. 194).

While all music has the potential to be ‘therapeu-tic’, music therapy is defined as ‘the creative andprofessionally informed use of music in a therapeu-tic relationship with people identified as needingphysical, psychosocial, or spiritual help, or with peopleaspiring to experience further self-awareness,enabling increased life satisfaction and quality’(O'Callaghan, in press). The purpose of the brief,time-limited, closed music therapy support group isto provide psycho-spiritual, existential support forcancer patients and survivors through active partic-ipation in various music and related creative-expressive experiences (Rykov, 2002). The musictherapy interventions vary according to the uniquecharacteristics and needs of each support group.

My music therapy practice is informed by 28 yearsof clinical work with individuals, singly and ingroups, of all ages and with diverse presenting issues.The music therapy group experience chronicled hereaddressed the needs of cancer patients and survivors.This music therapy support group model may beapplied to individuals facing other health challenges.

Concluding summary

I report the meanings of a music therapy support groupfor 10 adult cancer patients and survivors and describea music therapy support group model. The report is anarts-informed research representation of phenomeno-logical music therapy inquiry rooted in human sciencetheory and the interpretive research paradigm. I usealternative ways of representation to communicatemore directly and convey the ineffable quality ofmusic and other non-verbal therapeutic experiences. Iexpand the notion of reporting health-related researchoutcomes, including ways of knowing, what can beknown and how this can be represented.

The experiential music-centred focus of the musictherapy support group diminished differences of age,gender, cancers and disease stage. The participantstalked about feeling lonely and isolated as cancerpatients. They experienced the music therapy sup-port group as profound, non-verbal connection to

themselves, to each other and as connection tosomething larger—the music—beyond themselves.

The experience of improvised music making inthe music therapy support group was particularlyempowering. This provided opportunities for expe-riencing feelings of control during a time of loss-of-control inflicted by the disease and ensuingexperiences of illness. Furthermore, participantsexplored and expressed their own inherent creativ-ity that some were not aware they were capable of.The positive effects of the music therapy supportgroup were reported to be long-lasting.

Having read my intentions for, and explanationsabout, this research process and representation I inviteyou to re-visit the images and insights of the participants.

References

Austin, D., & Forinash, M. (2005). Arts-based research. InB. L. Wheeler (Ed.), Music therapy research (2nd edn,pp. 458–471). Gilsum, NH: Barcelona Publishers.

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Author biography

MARY RYKOV, a Fellow of the Association forMusic & Imagery, works through Music Therapy

Services (Toronto) and is a Postdoctoral Fellow inpalliative care research at McGill University.


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